July 28, 2014

The return of Ebola and the spread of fear

Mr. Sawyer’s death on Friday has led to tighter screening of airline passengers in West Africa, where an unprecedented outbreak that emerged in March has killed more than 670 people in Guinea, Sierra Leone and Liberia. But some health authorities expressed little confidence in such precautions.

“The best thing would be if people did not travel when they were sick, but the problem is people won’t say when they’re sick. They will lie in order to travel, so it is doubtful travel recommendations would have a big impact,” said David Heymann, professor of infectious diseases at the London School of Hygiene and Tropical Medicine.

“The important thing is for countries to be prepared when they get patients infected with Ebola, that they are isolated, family members are told what to do and health workers take the right steps.”

Still, detecting Ebola in departing passengers might be tricky, since its initial symptoms are similar to many other diseases, including malaria and typhoid fever.

“It will be very difficult now to contain this outbreak because it’s spread,” Dr. Heymann said. “The chance to stop it quickly was months ago before it crossed borders … But this can still be stopped if there is good hospital infection control, contact tracing and collaboration between countries.”

International travel has made the spread of disease via airplanes almost routine. Outbreaks of measles, polio and cholera have been traced back to countries thousands of kilometres away. Even Ebola previously travelled the globe this way: During an outbreak in Ivory Coast in the 1990s, the virus infected a veterinarian who travelled to Switzerland, where the disease was snuffed out upon arrival and she ultimately survived, experts say.

The World Health Organization is now awaiting laboratory confirmation after Nigerian health authorities said Mr. Sawyer tested positive for Ebola, WHO spokesman Gregory Härtl said. The WHO has not recommended any travel restrictions since the outbreak came to light.

“We would have to consider any travel recommendations very carefully, but the best way to stop this outbreak is to put the necessary measures in place at the source of infection,” Mr. Härtl said. Closing borders “might help, but it won’t be exhaustive or foolproof.”

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Mr. Sawyer’s death on Friday has led to tighter screening of airline passengers in West Africa, where an unprecedented outbreak that emerged in March has killed more than 670 people in Guinea, Sierra Leone and Liberia. But some health authorities expressed little confidence in such precautions.

“The best thing would be if people did not travel when they were sick, but the problem is people won’t say when they’re sick. They will lie in order to travel, so it is doubtful travel recommendations would have a big impact,” said David Heymann, professor of infectious diseases at the London School of Hygiene and Tropical Medicine.

“The important thing is for countries to be prepared when they get patients infected with Ebola, that they are isolated, family members are told what to do and health workers take the right steps.”

Still, detecting Ebola in departing passengers might be tricky, since its initial symptoms are similar to many other diseases, including malaria and typhoid fever.

“It will be very difficult now to contain this outbreak because it’s spread,” Dr. Heymann said. “The chance to stop it quickly was months ago before it crossed borders … But this can still be stopped if there is good hospital infection control, contact tracing and collaboration between countries.”

International travel has made the spread of disease via airplanes almost routine. Outbreaks of measles, polio and cholera have been traced back to countries thousands of kilometres away. Even Ebola previously travelled the globe this way: During an outbreak in Ivory Coast in the 1990s, the virus infected a veterinarian who travelled to Switzerland, where the disease was snuffed out upon arrival and she ultimately survived, experts say.

The World Health Organization is now awaiting laboratory confirmation after Nigerian health authorities said Mr. Sawyer tested positive for Ebola, WHO spokesman Gregory Härtl said. The WHO has not recommended any travel restrictions since the outbreak came to light.

“We would have to consider any travel recommendations very carefully, but the best way to stop this outbreak is to put the necessary measures in place at the source of infection,” Mr. Härtl said. Closing borders “might help, but it won’t be exhaustive or foolproof.”